Why does chemotherapy cause hair loss?

Chemotherapy attacks cells in our body that are rapidly growing, such as cancer cells. Some normal cells that also grow rapidly, like hair cells, are also affected.

Does all chemotherapy cause hair loss?

Many chemotherapy drugs have no affect on your hair. Others cause mild hair thinning or complete hair loss. Your doctor or nurse can tell you if hair loss is expected with your treatment.

Scalp hair is the most frequently affected, but loss of eyelashes, eyebrows, facial hair, pubic hair and body hair can also occur.

The degree of hair loss will depend on several factors, including the chemotherapy drug(s) and dose received, how it is given and other treatments.

When will the hair loss occur?

Hair loss usually begins 2 weeks after your first treatment. Some people notice achiness or tingling of the scalp as the hair loss begins. If complete hair loss is expected, the hair may come out in large amounts and is usually complete within 3-7days.

Is the hair loss permanent?

Hair loss caused by chemotherapy is usually temporary. Your hair will start to regrow after your treatment is completed. Some people experience a small amount of regrowth during treatment. Most people experience significant hair re-growth 3-5 months after treatment is completed. It is not uncommon for hair to grow back curlier and a slightly different color.

Can I apply cold caps to my scalp to decrease hair loss?

Discuss this option with your healthcare provider. Small studies have shown that products marketed as "cold caps" can reduce or prevent hair loss from chemotherapy in some patients. These work by decreasing the blood flow to the scalp and therefore prevent the chemotherapy from affecting the hair follicles. Some practitioners are concerned that this may also prevent the chemotherapy from reaching cancer cells that may be in the scalp area. However, several European studies have shown no increase in metastases to the scalp.

How should I care for my hair while receiving chemotherapy?

Even if your chemotherapy treatment is not expected to cause significant hair changes, some precautions are still recommended. If hair thinning is expected, these precautions may decrease damage to your hair:

Use a soft bristle brush

Use a gentle, pH balanced shampoo

Avoid using hair dryers, hot rollers or curling/flat irons too often

Avoid bleaching or coloring your hair

Avoid permanent waves

Avoid braiding or placing hair in a pony tail

Sleep on a satin pillowcase to decrease friction.

Wear a hat when in the sun

If your hair is long, cutting it shorter may help decrease the impact of your hair loss when it occurs.

Some people find it easier to deal with hair loss by shaving their heads before hair loss occurs.

Be sure to protect your head with a hat to prevent sun exposure on sunny days- and not just in the summer months! This is especially important for men who are less likely to wear a wig or turban/scarf.

Should I get a wig?

Each person responds differently when learning that they may experience partial or total hair loss. There is no right or wrong response. Do what's comfortable for you.

If you plan to purchase a wig, make an appointment with a wig stylist before the hair loss is expected so that the color, style and texture of your hair can be matched to a wig. If hair loss begins before your appointment with the wig stylist, save some pieces of your hair and take them with you.

Types of wigs:

Natural hair: More expensive and requires more care

Synthetic: Less expensive

Can I get help paying for a wig for when I lose my hair from chemotherapy?

Some health insurance policies cover the cost of wigs; you just have to know their language—usually they are referred to as "cranial hair replacement." You should contact your insurance company first to see if you have any coverage. You may need to ask your healthcare provider for a prescription in order to get reimbursement.

Secondly, the American Cancer Society in some areas can help to cover the cost of a wig up to $75. You should also see if your oncologist's office has a copy of the "TLC" catalog, which is published by the American Cancer Society and offers a wide selection of lovely wigs, turbans and head coverings.

Consider scarves, turbans and hats to conceal hair loss.

They are cooler, can be more comfortable and overall require less care than wigs. There are many attractive, stylish, and creative head covers available.

Why am I so upset about my hair loss?

It is normal to be upset about hair loss from cancer treatment. It may affect how you feel about yourself. It is also a visible reminder of your cancer. Share your feelings with your doctor, nurse, family and friends. There are many educational and supportive programs available.